How to Get Help for Overactive Bladder (Even If It’s Embarrassing)
OAB can be treated—and there are plenty of doctors ready to help.
Whether you’re just noticing symptoms of overactive bladder or you’ve been dealing with it for months, you know that having incontinence can take a huge toll on your work, personal, and emotional life. The urge to pee can come on at the most inconvenient times, and the unpredictability can be stressful, to say the least. “That first morning cup of coffee suddenly becomes problematic. That second glass of wine when you’re out to dinner with friends suddenly doesn’t look so good anymore,” says Lauri Romanzi, MD, a urogynecologist in New York City.
Having to anticipate your next bathroom trip, or worry that you’ll have to interrupt something important to go pee—like a work presentation, or while you’re having sex—can impact your quality of life, causing frustration, anxiety, and distress. “[Patients] begin to restrict how they behave and what they chose for themselves in an attempt to control that terrible feeling of urgency.”
Dr. Romanzi says that many patients who feel OAB symptoms initially try to self diagnose, not realizing that there are multiple forms of incontinence. This can then lead to frustration and anxiety when self-treatment remedies don’t seem to work. “And, no surprise, the anxiety makes everything worse, particularly the overactive bladder,” says Dr. Romanzi.
The best way to diagnose and treat overactive bladder is to see a doctor. There are many treatment options for OAB, from behavior modifications (such as avoiding bladder-irritating foods, starting a bladder diary, and doing Kegel exercises) to medications and, in more severe cases, Botox or surgery. Your doctor will be able to evaluate your symptoms and find the best possible treatment for your lifestyle and health needs.
In terms of seeing a clinician, however, Dr. Romanzi says there’s one important thing to remember: “There are still clinicians who will tell patients that there’s nothing they can do [about OAB],” she says. “I would tell any patient who’s having that type of response from any clinician to be your own advocate. Go online at the local university, look up incontinence, and find someone who can help you.”
The sooner you get evaluated by the right doctor, the sooner you can treat your symptoms. “There’s no reason to sit and wait and to accept that nothing can be done. The key message is don’t be embarrassed. There are plenty of doctors who are ready to help with this type of problem,” says Dr. Romanzi.
Dr. Romanzi is a urogynecologist and reconstructive pelvic surgeon based in New York City.
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It can affect your social life,
it can affect your habits.
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That first morning cup of coffee
suddenly becomes problematic.
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That second glass of wine when
you're out to dinner with friends
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suddenly doesn't look so good anymore.
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They begin to restrict how they behave and
what they choose for
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themselves in an attempt to control
that terrible feeling of urgency.
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Can you imagine, you literally
feel like you have to urinate and
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you're sitting at dinner with friends.
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And you're not sure if you can
get up from your chair in time
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to get to the bathroom without running or
without leaking on the way.
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If these symptoms are causing enough
quality of life impact that they're
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terribly bothered and
want to do something about it,
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by definition,
they have overactive bladder.
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The anxiety makes everything worse,
particularly the overactive bladder.
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And these types of patients often
come in discouraged before you
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even begin the evaluation.
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Because they come to you as a last resort,
and behind all of that, they're terribly
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worried that nothing's going to work,
and they're stuck being incontinent.
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The diagnosis of overactive bladder is
interactive between the patient and
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the clinician that's evaluating them.
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Believe it or not, there are still
some clinicians who will tell
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patients that there's nothing they can do.
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So you're getting up
a couple of times a night?
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So you didn't make it to the bathroom and
now you're worried all the time?
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This type of messaging is unfortunate but
it's still happening.
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I would tell any patient who's having that
type of response from any clinician to be
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your own advocate, to look in your health
care manual from the insurance company,
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to go online at the local university and
lookup incontinence.
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And find someone who can help you.
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There's no reason to sit and wait and
to accept that nothing can be done.
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The key message is don't be embarrassed.
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There are plenty of doctors who are ready
to help with this type of problem.
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Bladder Control Problems in Women (Urinary Incontinence). Bethesda, MD. National Institute of Digestive and Kidney Diseases. (Accessed on April 10, 2021 at https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women)
Evaluation of women with urinary incontinence. Waltham, MA. UpToDate, 2020. (Accessed on April 10, 2021 at https://www.uptodate.com/contents/evaluation-of-women-with-urinary-incontinence)